Healthcare Provider Details

I. General information

NPI: 1831717925
Provider Name (Legal Business Name): DANIELLE TREADWAY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2020
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

897 IRONWOOD DR
MINDEN NV
89423-5198
US

IV. Provider business mailing address

170 GALENA WAY
CARSON CITY NV
89706-1963
US

V. Phone/Fax

Practice location:
  • Phone: 775-782-1615
  • Fax:
Mailing address:
  • Phone: 916-289-2135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number816258
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: